scholarly journals Effect of Expanded Hemodialysis with Theranova® in Patients with COVID-19

2022 ◽  
pp. 1-9
Author(s):  
María Luisa Serrano Salazar ◽  
Jose Portolés ◽  
Maria de Valdenebro Recio ◽  
Silvia Rosado Garcia ◽  
Maria del Rosario Llópez Carratalá ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Statistical Significance ◽  
Immunosuppressive Treatment ◽  
Kidney Injury ◽  
Small Sample ◽  
Control Group ◽  
Β2 Microglobulin ◽  
Cytokine Levels ◽  
To Come ◽  
And Control

<b><i>Introduction:</i></b> Cytokine storm control is the main target for improving severe COVID-19 by using immunosuppressive treatment. Effective renal replacement therapy (RRT) could give us an advantage removing cytokines in patients with RRT requirements superimposed on COVID-19. <b><i>Methods:</i></b> This is a prospective observational study in COVID-19 patients who required hemodialysis (HD). Patients were assigned to online hemodiafiltration (OL-HDF) and expanded HD (HDx) according to Brescia group recommendations. We measured several cytokines, β2 microglobulin and albumin levels pre/post-dialysis and on 1st–2nd week. We compared levels among both techniques and control group (HD without COVID-19). <b><i>Results:</i></b> We included 26 patients: 18 with COVID-19 on RRT (5 of them had acute kidney injury [AKI]) and 8 controls. We confirm higher cytokine levels in COVID-19 patients than controls and even higher in patients with AKI than in those with chronic kidney disease. Most cytokines raised during HD session, except IL-10 and TNFα. IL-10 was eliminated by any dialysis technique, while clearance of TNFα was higher in the HDx group. HDx achieved a deeper normalization of cytokines and β2 microglobulin reduction. Mortality was higher in the OL-HDF group than the HDx group. <b><i>Discussion:</i></b> Not all cytokines behave equally along HD session. The following characteristics should be taken into account, such as intrinsic kinetic profile during a HD session. HDx seems to get better performance, probably due to the combination of different factors; however, we did not reach statistical significance due to the small sample size, dropout, and reduction of AKI incidence during the 2nd pandemic wave. <b><i>Conclusion:</i></b> HDx appears to provide better clearance for TNFα and β2 microglobulin during HD session and associates lower mortality. We propose the HDx technique for COVID-19 patients with RRT requirements since it seems to be safe and more effective than OL-HDF. Further studies are still needed, but we hope that our preliminary data may help us in future pandemic waves of SARS-CoV-2 or other viruses still to come.

Abstract 276: Asymmetric Dimethylarginine Is A Potential Risk Factor For Transient Ischemic Attack

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Yuanjin Zhang ◽  
Daniel Laskowitz ◽  
Dongsheng Fan
Keyword(s):  
Growth Factor ◽  
Transient Ischemic Attack ◽  
Asymmetric Dimethylarginine ◽  
Small Sample Size ◽  
Small Sample ◽  
Control Group ◽  
Acute Infarction ◽  
Abcd2 Score ◽  
Ischemic Attack ◽  
And Control

Objective: Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase which has been shown to be involved in the pathogens of atherosclerosis. Vascular endothelial growth factor (VEGF) is apleiotropic growth factor involved in neurovascular remodeling in the cerebral ischemia disease. ADMA has been validated to be a risk marker of stroke and transient ischemic attack (TIA). VEGF has been demonstrated associated with risk of stroke. This pilot study aimed to verify the correlation between serum ADMA, VEGF levels and ABCD2 score which has been validated to predict short term risk of stroke following transient ischemic attack (TIA). Methods: TIA was defined as a transient episode of neurologic dysfunction caused by focal brain, spinal cord or retinal ischemia, without acute infarction even the focal transient neurologic symptoms last less than one hour. We enrolled 40 TIAs and 40 healthy controls in Peking University Third Hospital Neurology wards and clinics since May to July 2013. The TIA diagnosis and ABCD2 score evaluation is conducted by the same neurology physician. The mean age of TIAs and controls was 61.9±12.9yrs and 63.4±10.9yrs respectively (P=0.544). Blood samples were drawn within 24 hours after the TIA diagnosis clarified. ADMA and VEGF levels were measured by ELISA. Result: The ADMA levels in TIAs and control group are 0.52±0.06mmol/L and 0.23±0.04mmol/L (t=24.14, P<0.01). The VEGF levels in TIAs and control group are 272.01±26.36mmol/L and 148.87±21.05mmol/L (t=24.65, P<0.01). In the non-stroke history TIAs (23 cases) sub-group the spearman correlation coefficient between ADMA and ABCD2 score is 0.6(P=0.002). Conclusion: ADMA and VEGF are absolutely increased in TIAs. There is no correlation between ADMA, VEGF, age, sex, blood pressure, glucose and ABCD2 in this small sample size population. But ADMA is probably associated with risk of TIA with no-stroke history. Thus, these findings reveal a possibly new challenging potential of the ADMA and VEGF role in the pathogenesis of TIA.

scholarly journals Coronavirus disease-2019 in cancer patients. A report of the first 25 cancer patients in a western country (Italy)

2020 ◽  
Vol 16 (20) ◽  
pp. 1425-1432 ◽  
Author(s):  
Elisa Maria Stroppa ◽  
Ilaria Toscani ◽  
Chiara Citterio ◽  
Elisa Anselmi ◽  
Elena Zaffignani ◽  
...  
Keyword(s):  
Sample Size ◽  
Antiviral Therapy ◽  
Cancer Patients ◽  
General Hospital ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Western Country ◽  
Small Sample ◽  
Control Group ◽  
Worse Prognosis

Background: We describe cancer patients with coronavirus disease-2019 (COVID-19) infection treated at the Piacenza’s general hospital (north Italy). Materials & methods: 25 cancer patients infected by COVID-19 admitted at the Piacenza’s general hospital from 21 February to 18 March 2020. Outcome from the infection were compared with infected noncancer patients. Results: 20 patients (80%) were treated with antiviral therapy and hydroxychloroquine and five (20%) received hydroxychloroquine alone. Nine (36%) patients died, while 16 (64%) overcome the infection. In the control group the mortality was 16.13% and the overcome from infection was 83.87%. Conclusion: Mortality for COVID-19 was greater in cancer patients when compared with noncancer patients, worse prognosis for older age, women and patients treated with hydroxychloroquine alone. However, the comparisons did not reach statistical significance in most cases. This could be due to the small sample size that is the main limitation of the study.

scholarly journals Maternally and Paternally Silenced Imprinted Genes Differ in Their Intron Content

2004 ◽  
Vol 5 (8) ◽  
pp. 572-583 ◽  
Author(s):  
Marie E. Fahey ◽  
Walter Mills ◽  
Desmond G. Higgins ◽  
Tom Moore
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Control Group ◽  
Imprinted Genes ◽  
Intronless Genes ◽  
Intron Content ◽  
Group A ◽  
Control Set ◽  
And Control ◽  
Human And Mouse

Imprinted genes exhibit silencing of one of the parental alleles during embryonic development. In a previous study imprinted genes were found to have reduced intron content relative to a non-imprinted control set (Hurstet al., 1996). However, due to the small sample size, it was not possible to analyse the source of this effect. Here, we re-investigate this observation using larger datasets of imprinted and control (non-imprinted) genes that allow us to consider mouse and human, and maternally and paternally silenced, imprinted genes separately. We find that, in the human and mouse, there is reduced intron content in the maternally silenced imprinted genes relative to a non-imprinted control set. Among imprinted genes, a strong bias is also observed in the distribution of intronless genes, which are found exclusively in the maternally silenced dataset. The paternally silenced dataset in the human is not different to the control set; however, the mouse paternally silenced dataset has more introns than the control group. A direct comparison of mouse maternally and paternally silenced imprinted gene datasets shows that they differ significantly with respect to a variety of intron-related parameters. We discuss a variety of possible explanations for our observations.

Association of losartan use with outcomes in metastatic pancreatic cancer patients treated with chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16738-e16738
Author(s):  
Jessica Allen ◽  
Kathan Mehta ◽  
Shrikant Anant ◽  
Prasad Dandawate ◽  
Anwaar Saeed ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Metastatic Cancer ◽  
Statistical Significance ◽  
Objective Response ◽  
Locally Advanced ◽  
Small Sample ◽  
Ductal Adenocarcinoma ◽  
Control Group ◽  
100Mg Dose ◽  
Significant Difference

e16738 Background: A phase II trial has shown improved efficacy of neoadjuvant therapy when combined with losartan (by remodeling desmoplasia) in locally advanced pancreatic ductal adenocarcinoma (PDA). However, role of losartan is unknown in metastatic PDA. We examined the relationship between the use of the angiotensin II receptor antagonist, losartan, at time of diagnosis with clinical outcomes in metastatic PDA pts that received chemo. Methods: We retrospectively evaluated 114 metastatic PDA pts treated at our center between Jan 2000 and Nov 2019. We compared OS, PFS, objective response rate (ORR), and disease control rate (DCR) between pts using losartan at time of cancer diagnosis and a control group of pts not on losartan. A subanalysis was performed based on losartan dose: 100mg dose versus control pts. and based on chemo: FOLFIRINOX or gemcitabine+abraxane. Results: Table shows baseline demographics. No significant difference was found in OS [p = 0.455] or PFS [p = 0.919] in pts on losartan (median 274d, 83d) vs control (median 279d, 111d) [p = 0.466]. No significant difference was found in ORR [p = 0.621] or in DCR [p = 0.497]. No significant difference was found in OS [p = 0.771] or PFS [p = 0.064] in losartan pts (median 347d, 350d) vs control (median 333d, 101d) treated with FOLFIRINOX. No significant difference was found in OS [p = 0.916] or PFS [p = 0.341] in losartan (median 312d, 69d) vs control (median 221d, 136d) [p = 0.916] treated with gemcitabine+abraxane. No significant difference was found in OS [p = 0.727] or PFS [p = 0.790] in 100mg losartan pts (median 261d, 84d) vs control (median 279d, 111d). Conclusions: Pts on losartan at time of diagnosis had no significant difference in OS, PFS, ORR, DCR than control pts. However, a subanalysis of pts treated with FOLFIRINOX revealed a longer PFS with losartan than control but did not meet statistical significance, likely due to small sample size. To confirm if the benefit of losartan + FOLFIRINOX seen in neoadjuvant setting for locally advanced cancer also applies to metastatic cancer, our findings need to be validated in a larger cohort. [Table: see text]

Relationship between fatigue and cytokine levels in patients age 50+ with acute myeloid leukemia (AML)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19566-19566
Author(s):  
A. Panju ◽  
D. Kelvin ◽  
M. D. Minden ◽  
S. M. Alibhai
Keyword(s):  
Small Sample Size ◽  
Statistical Significance ◽  
Best Supportive Care ◽  
Small Sample ◽  
Published Data ◽  
European Organization ◽  
Effective Prevention ◽  
Time Points ◽  
Markers Of Inflammation ◽  
Cytokine Levels

19566 Background: Fatigue is the most common and disabling symptom affecting patients with AML; effective prevention or treatment measures have yet to be found. Cytokines, biological markers of inflammation, may represent a major cause of fatigue, but published data are limited. Methods: Patients age 50 or older with AML were recruited between May and September 2006. All patients were fluent in English, within one year of diagnosis, and free of any other active malignancy. Fatigue was measured using the Functional Assessment of Cancer Therapy (FACT) Fatigue subscale, a single-item global fatigue scale, and the European Organization for the Research and Treatment of Cancer (EORTC) QLQ-C30. Blood was simultaneously drawn for quantitative measurement of a panel of 13 cytokines. Repeat measurements were done 4–6 weeks later. Correlational analysis was used to examine relationships between individual cytokines and fatigue scores. Changes in fatigue scores between time points were correlated with changes in cytokine levels. Results: 34 patients (23 men; 11 women) were enrolled (mean age 67 y; range 52–84). 27% had not started chemotherapy or were receiving best supportive care, while the rest were undergoing active chemotherapy. At baseline, a weak correlation (r=0.332, p=0.059) was seen with interleukin (IL)-6 and at least one fatigue measure. No correlations (r<0.30) were observed with any of the other cytokines (interferon (IFN)-?, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IP-10, MCP-1, MiG, and tumor necrosis factor-a) and any fatigue measure. Follow-up data were available for 29 patients. A statistically significant correlation with fatigue was seen with IL-2 (r=0.407, p=0.032), and clinically-important correlations that did not achieve conventional statistical significance were seen with IFN-? (r=0.331, p=0.085), IL-5 (r=0.344, p=0.073), and IL-10 (r=0.326, p=0.091). Conclusions: Based on these data, the most promising cytokine-fatigue relationship was noted with IL-2. However, IFN-?, IL-5, IL-6, and IL-10 also showed potentially important relationships with fatigue. Given our small sample size and patient enrolment at differing time points during their treatment course, further controlled studies are warranted. No significant financial relationships to disclose.

Outcome of children with Shiga toxin-associated haemolytic uraemic syndrome treated with eculizumab: a matched cohort study

2019 ◽  
Vol 35 (12) ◽  
pp. 2147-2153 ◽  
Author(s):  
Catherine Monet-Didailler ◽  
Audrey Chevallier ◽  
Astrid Godron-Dubrasquet ◽  
Lise Allard ◽  
Yahsou Delmas ◽  
...  
Keyword(s):  
Cohort Study ◽  
Shiga Toxin ◽  
Small Sample Size ◽  
Kidney Injury ◽  
Small Sample ◽  
Renal Outcome ◽  
Control Group ◽  
Matched Cohort ◽  
Matched Cohort Study

Abstract Background Treatment with eculizumab in Shiga toxin–associated haemolytic and uraemic syndrome (STEC-HUS) remains controversial despite its increasing utilization. The aim of our study was to evaluate the outcomes of children treated with eculizumab for STEC-HUS in a single-centre matched cohort study. Methods Data were retrospectively collected from medical records of children diagnosed with STEC-HUS. The outcomes of patients treated with eculizumab for STEC-HUS were compared with those of a control group of untreated patients matched for age, sex and severity of acute kidney injury with a 1:2 matching scheme. Results Eighteen children (median age 40.6 months) with STEC-HUS treated with eculizumab were compared with 36 matched control patients (median age 36.4 months) who did not receive eculizumab. All patients survived in the two groups. Within 1 month of HUS onset, the evolution of haematological and renal parameters did not differ between the two groups. At 12 months of follow-up, renal outcome was not significantly different between the two groups. At the last follow-up, the prevalence of decreased glomerular filtration rate in the eculizumab group (27%) was not statistically different from that in controls (38%), as was the prevalence of proteinuria and high blood pressure. Children who received eculizumab more often had extrarenal sequelae during follow-up. Eculizumab treatment appeared to be safe in children with STEC-HUS. Conclusion The benefit of eculizumab on renal and extrarenal outcomes in STEC-HUS could not be established based on our findings. However, efficacy and safety are not best assessed by the observational design and small sample size of our study. Randomized controlled trials are thus required to determine the efficacy of eculizumab in this indication.

scholarly journals Effects of Cancer, Chemotherapy and Cytokines on Subjective and Objective Cognitive Functioning Among Patients with Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2576
Author(s):  
Vincent Chin-Hung Chen ◽  
Chin-Kuo Lin ◽  
Han-Pin Hsiao ◽  
Bor-Show Tzang ◽  
Yen-Hsuan Hsu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Function ◽  
Cognitive Abilities ◽  
Verbal Fluency ◽  
Control Group ◽  
Control Groups ◽  
Semantic Verbal Fluency ◽  
Cytokine Levels ◽  
Chemotherapy Patients ◽  
And Control

Background: We aimed to investigate the associations of breast cancer (BC) and cancer-related chemotherapies with cytokine levels, and cognitive function. Methods: We evaluated subjective and objective cognitive function in BC patients before chemotherapy and 3~9 months after the completion of chemotherapy. Healthy volunteers without cancer were also compared as control group. Interleukins (IL) 2, 4, 5, 6, 10, 12p70, 13, 17A, 1β, IFNγ, and TNFα were measured. Associations of cancer status, chemotherapy and cytokine levels with subjective and objective cognitive impairments were analyzed using a regression model, adjusting for covariates, including IQ and psychological distress. Results: After adjustment, poorer performance in semantic verbal fluency was found in the post-chemotherapy subgroup compared to controls (p = 0.011, η2 = 0.070); whereas pre-chemotherapy patients scored higher in subjective cognitive perception. Higher IL-13 was associated with lower semantic verbal fluency in the post-chemotherapy subgroup. Higher IL-10 was associated with better perceived cognitive abilities in the pre-chemotherapy and control groups; while IL-5 and IL-13 were associated with lower perceived cognitive abilities in pre-chemotherapy and control groups. Our findings from mediation analysis further suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Conclusions: Our findings suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Different cytokines and their interactions may have different roles of neuroinflammation or neuroprotection that need further research.

scholarly journals Longitudinal assessment of S100B serum levels and clinical factors in youth patients with mood disorders

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aleksandra Rajewska-Rager ◽  
Monika Dmitrzak-Weglarz ◽  
Pawel Kapelski ◽  
Natalia Lepczynska ◽  
Joanna Pawlak ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Calcium Binding ◽  
Clinical Symptoms ◽  
Small Sample Size ◽  
Serum Levels ◽  
Small Sample ◽  
Drop Out ◽  
Control Group ◽  
Longitudinal Assessment ◽  
Depressed Group

AbstractMood disorders have been discussed as being in relation to glial pathology. S100B is a calcium-binding protein, and a marker of glial dysfunctions. Although alterations in the S100B expression may play a role in various central nervous system diseases, there are no studies on the potential role of S100B in mood disorders in adolescents and young adults . In a prospective two-year follow-up study, peripheral levels of S100B were investigated in 79 adolescent/young adult patients (aged 14–24 years), diagnosed with mood disorders and compared with 31 healthy control subjects. A comprehensive clinical interview was conducted which focused on clinical symptoms and diagnosis change. The diagnosis was established and verified at each control visit. Serum S100B concentrations were determined. We detected: lower S100B levels in medicated patients, compared with those who were drug-free, and healthy controls; higher S100B levels in a depressed group with a family history of affective disorder; correlations between age and medication status; sex-dependent differences in S100B levels; and lack a of correlation between the severity of depressive or hypo/manic symptoms. The results of our study indicate that S100B might be a trait-dependent rather than a state-dependent marker. Due to the lack of such studies in the youth population, further research should be performed. A relatively small sample size, a lack of exact age-matched control group, a high drop-out rate.

Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series

2021 ◽  
pp. 039156032110351
Author(s):  
Alessandro Uleri ◽  
Rodolfo Hurle ◽  
Roberto Contieri ◽  
Pietro Diana ◽  
Nicolòmaria Buffi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Advanced Disease ◽  
Independent Predictor ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Small Sample ◽  
Locally Advanced Disease ◽  
Increased Risk

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Methods: We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. Results: A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282–11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027–1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312–6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374–6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12–6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95–5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623–0.795). Limitations include the retrospective nature of the study and the relatively small sample size.

ECT rekindles pharmacological response in schizophrenia

2009 ◽  
Vol 24 (8) ◽  
pp. 521-525 ◽  
Author(s):  
H. Hustig ◽  
R. Onilov
Keyword(s):  
Small Sample Size ◽  
Antipsychotic Agents ◽  
Pharmacological Therapy ◽  
Small Sample ◽  
Clinical Population ◽  
Control Group ◽  
Clinical Notes ◽  
Symptom Profiles ◽  
Pharmacological Response ◽  
Maintenance Ect

AbstractObjectiveThe aim of our naturalistic-observational study was to determine the efficacy and utility of electroconvulsive therapy (ECT) in clinical population of individuals with schizophrenia where pharmacological response was suboptimal.MethodsThe cohort comprised 27 patients suffering from schizophrenia with refractoriness to antipsychotic agents and with severe, disabling symptoms. They only interventional assessing tool was clinical global impression (CGI-S) performed at the baseline and at the end of the treatment.ResultsThe administration of ECT resulted in overall clinical improvement reflected in CGI scales and descriptions in clinical notes. On 12 months follow-up period, 10 patients (37.1%) maintained improvement and were able to continue with pharmacological therapy only, suggesting its rekindling effect, especially with Clozapine. Conversely, 17 patients (62.9%) deteriorated and required an additional course of ECT to maintain improvement. In some cases, maintenance ECT treatment was required. The group who engaged in self-harming behaviour at baseline demonstrated they were more likely to relapse into psychosis at the end of the first course of ECT, their self-harming behaviour abated, especially when maintenance ECT was undertaken.ConclusionsAlthough limited by lack of control group, small sample size, heterogeneous symptom profiles and various concurrent neuroleptic agents, the ECT proved as valuable and safe augmentative procedure when unsatisfactory response to pharmacological interventions had been demonstrated prior to interventions. This effect was evident despite the chronicity of the illness.

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